Member Type:
Player
Coach
Manager
Last Name:
First
Name:
MI:
Address:
City:
State:
Zip:
(no
dashes)
Date
of Birth:
(enter
with slashes mm/dd/yyyy)
Country: Foreign Postal
Code: (if not USA)
Citizen:
Gender:
Male
Female
Phone #1:
Phone
#2:
Phone
#3:
(no spaces, slashes or parenthesis ("1234567890")
Parent/Guardian
First Name:
Last Name:
E-Mail Address:
E-Mail Address:
______________________________________________________________________
Registration for:
Last Years Team: Last
Years Coach:
Primary Position: Forward
Defense Goaltender
Shot / Catch:
Right
Left
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________